Evaluation of novel programs in health counseling – their effectiveness in the oral health of young children, and their acceptance by parents and professionals in public dental service.

Aim and design: To evaluate family-based health counseling for young children, and to study the significance of adding parental self-care or the training of professionals to the programs. The effectiveness and acceptability of the programs were evaluated by comparing two new programs with an earlier one. Subjects and methods: The study was carried out in Vantaa, which was divided into three study areas. The subjects consisted of children born in 2008, particularly fi rstborn children, while children born in 2006 formed the historical control. The fi rst of the new programs emphasized oral hygiene and use of fl uoride, and the second program focused on proper diet and use of xylitol. The main outcome measure was mutansstreptococci (MS) in the dental biofi lm of two-year-olds, and the opinions of parents and dental professionals were evaluated using questionnaires. Results: The programs found wide acceptance among dental professionals. There were no group-related differences found in the MS scores of the two-year-olds. However, all groups combined, father’s advanced level of education and child’s proper use of xylitol were associated with negative MS scores. In the opinion of parents, the oral healthcare guidance at least somewhat met their expectations. Conclusions: The present fi ndings suggest that providing training and support for professionals in health education is important. The addition of parental self-care to supplement programs aimed at young children does not improve the program, although it may improve parental readiness to change their own health habits. Counseling for families might be best carried out through a routine patient-centered program.

The role of self-presentation in adolescent health risk behaviours

Self-presentation has been identified as playing a key role in the perfonnance of various potentially hazardous health behaviours such as substance abuse, eating disorders and reckless behaviours (Leary, Tchividjian, & Kraxberger, 1994; Martin & Leary, 2001; Martin, Leary, & O'Brien, 2001). The present study investigated the role of selfpresentation on adolescent health-risk behaviours. Specifically, this study examined the prevalence of adolescent identified health-risk behaviours rooted in self-presentational motives in youths aged 13-18 years. The current study also identified the specific images associated with these behaviours desired by youth, and the targets of these behaviours. Also, the relationship between these behaviours, and several trait measures (social physique anxiety, public-self consciousness, fear of negative evaluations, selfpresentational efficacy) of self-presentation were examined. Finally, the gender differences in health risk behaviours and self-presentational concerns were examined. Participants in the present study were 96 adolescent students, 34 male and 62 female, recruited from various private schools across Southern Ontario. Students ranged in age from 13 to 18 years for both males (M age = 15.81 years, SD = 1.49) and females (M age = 14.89 years, SD = 1.17) and ranged from grades 8 through 13. Results of the current study suggested that Canadian adolescents between the ages of 13 and 18 years participated in health risk behaviours for self-presentational purposes. Drinking alcohol, skipping school, and performing stunts and dares were identified as the most common health risk behaviours performed for self-presentational purposes by both males and females. Appearing fun and cool were the most commonly reported desired images while appearing brave and mature were the least reported. The most desired target group cited was same sex friends, followed by other sex friends. Trait measures of self-presentational concerns identified females as being higher in public self-consciousness, and social physique anxiety than males. Males were found to be higher in self-presentational efficacy than females. The total number of health risk behaviours was predicted by selfpresentational efficacy and social physique anxiety for males, and social physique anxiety for females. Findings of the current study suggest that Canadian adolescents' health risk behaviours are rooted, in part, in self-presentational motives. Thus far, an educational approach to health interventions has been favoured and/or adopted by teachers, health promoters, and educators (Jessor, 1992). Implications of the current study suggest that although educational interventions are beneficial in presenting the associated risks with certain activities and/or behaviours, one reason this type of approach may be ineffective in changing adolescent behaviour over the long run is that it does not address the strong and prominent influences of interpersonal motives on health damaging behaviour. It is evident that social acceptance and public image are of importance to adolescents, and the desire to make the "right" impression and to achieve peer approval and acceptance often override health and safety concerns (Jessor, 1992). Thus, a self-presentational approach focusing on changing the images associated with the behaviours may be more successful at deterring adolescent health risk behaviours.

The self-management approach of health education in the treatment of chronic illnesses

Health education is essential to the successful treatment of individuals with chronic illnesses. Self-management is a philosophical model of health education that has been shown to be effective in teaching individuals with chronic arthritis to manage their illness as part of their daily lives. Despite the proven results of arthritis self-management programs, some limitations of this form of health education were apparent in the literature. The present study attempted to address the problems of the self-management approach of health education such as reasons for lack of participation in programs and poor course outcomes. In addition, the study served to investigate the relationship between course outcomes and participation in programs with the theory upon which arthritis self-management programs are based, known as self-efficacy theory. Through a combination of qualitative and quantitative methodologies, data collection, and analysis, a deeper understanding of the self-management phenomenon in the treatment of chronic arthritic conditions was established. Findings of the study confirm findings of previous studies that suggest that arthritis self-management programs result in enhanced levels of self-efficacy and are effective in teaching individuals with arthritis to self-manage their health and health care. Findings of the study suggest that there are many factors that determine the choice of participants to participate in programs and the outcomes for the individuals who do choose to participate in programs. Some of the major determinants of enrollment and outcomes of programs include: the participant's personality, beliefs, attitudes and abilities, and the degree of emotional acceptance of the illness. Other determinants of course enrollment and outcomes included class size and length of time, timing of participation, and ongoing support after the program. The results of the study are consistent with the self-management literature and confirm the relationship between the underlying philosophies of adult education and Freire's model of education and self-management.

The Human in the Loop: User Participation in Self-Adaptive Software

Self-adaptive software provides a profound solution for adapting applications to changing contexts in dynamic and heterogeneous environments. Having emerged from Autonomic Computing, it incorporates fully autonomous decision making based on predefined structural and behavioural models. The most common approach for architectural runtime adaptation is the MAPE-K adaptation loop implementing an external adaptation manager without manual user control. However, it has turned out that adaptation behaviour lacks acceptance if it does not correspond to a user’s expectations – particularly for Ubiquitous Computing scenarios with user interaction. Adaptations can be irritating and distracting if they are not appropriate for a certain situation. In general, uncertainty during development and at run-time causes problems with users being outside the adaptation loop. In a literature study, we analyse publications about self-adaptive software research. The results show a discrepancy between the motivated application domains, the maturity of examples, and the quality of evaluations on the one hand and the provided solutions on the other hand. Only few publications analysed the impact of their work on the user, but many employ user-oriented examples for motivation and demonstration. To incorporate the user within the adaptation loop and to deal with uncertainty, our proposed solutions enable user participation for interactive selfadaptive software while at the same time maintaining the benefits of intelligent autonomous behaviour. We define three dimensions of user participation, namely temporal, behavioural, and structural user participation. This dissertation contributes solutions for user participation in the temporal and behavioural dimension. The temporal dimension addresses the moment of adaptation which is classically determined by the self-adaptive system. We provide mechanisms allowing users to influence or to define the moment of adaptation. With our solution, users can have full control over the moment of adaptation or the self-adaptive software considers the user’s situation more appropriately. The behavioural dimension addresses the actual adaptation logic and the resulting run-time behaviour. Application behaviour is established during development and does not necessarily match the run-time expectations. Our contributions are three distinct solutions which allow users to make changes to the application’s runtime behaviour: dynamic utility functions, fuzzy-based reasoning, and learning-based reasoning. The foundation of our work is a notification and feedback solution that improves intelligibility and controllability of self-adaptive applications by implementing a bi-directional communication between self-adaptive software and the user. The different mechanisms from the temporal and behavioural participation dimension require the notification and feedback solution to inform users on adaptation actions and to provide a mechanism to influence adaptations. Case studies show the feasibility of the developed solutions. Moreover, an extensive user study with 62 participants was conducted to evaluate the impact of notifications before and after adaptations. Although the study revealed that there is no preference for a particular notification design, participants clearly appreciated intelligibility and controllability over autonomous adaptations.

Maximal inflammatory response benefits syngeneic skin graft acceptance

Objective: We investigated the influence of acute inflammation in skin isograft acceptance. Methods: Two mouse lines selected for maximal (AIR(MAX)) or minimal inflammatory response (AIR(MIN)) were transplanted with syngeneic skin. Cellular infiltrates and cytokine production were measured 1, 3, 7 or 14 days post-transplantation. The percentage of CD4(+) CD25(+) Foxp3(+) cells in the lymph nodes was also evaluated. Results: Grafts were totally accepted in 100% of AIR(MAX) and in 26% of AIR(MIN) mice. In the latter, partial acceptance was observed in 74% of the animals. Emigrated cells were basically PMN and were enhanced in AIR(MAX) transplants. IL-10 production by graft infiltrating cells showed no interline differences. IFN-gamma was increased in AIR(MIN) grafts at day 14 and lower percentages of CD4(+)CD25(+)Foxp3(+) cells in the lymph nodes were observed in these mice. Conclusions: Our data suggest that differences in graft acceptance might be due to a lack of appropriate regulation of the inflammatory response in AIR(MIN) mice compromising the self/non-self recognition.

Xenomelia: a social neuroscience view of altered bodily self-consciousness

Xenomelia, the "foreign limb syndrome," is characterized by the non-acceptance of one or more of one's own extremities and the resulting desire for elective limb amputation or paralysis. Formerly labeled "body integrity identity disorder" (BIID), the condition was originally considered a psychological or psychiatric disorder, but a brain-centered Zeitgeist and a rapidly growing interest in the neural underpinnings of bodily self-consciousness has shifted the focus toward dysfunctional central nervous system circuits. The present article outlays both mind-based and brain-based views highlighting their shortcomings. We propose that full insight into what should be conceived a "xenomelia spectrum disorder" will require interpretation of individual symptomatology in a social context. A proper social neuroscience of xenomelia respects the functional neuroanatomy of corporeal awareness, but also acknowledges the brain's plasticity in response to an individual's history, which is lived against a cultural background. This integrated view of xenomelia will promote the subfield of consciousness research concerned with the unity of body and self.

Internet-based self-help for schizophrenia – risks and chances

Purpose: Schizophrenia is a severe mental disorder which is accompanied by an enormous individual and societal burden. Despite established efficacy of cognitive behavioral therapy (CBT) for schizophrenia, its dissemination into routine mental health care remains poor. Internet-based cognitive behavioral therapy in a self-help format helps to narrow the treatment gap in many mental disorders. Are Internet-based self-help programs, which are based on the principles of CBT, also feasible and viable for patients with schizophrenia? Methods: Mental health professionals (target N=50) as well as individuals with schizophrenia spectrum disorders (target N=50) reported their opinion regarding potential chances and risks of Internet-based self-help for schizophrenia in an online survey. Results: The preliminary data analysis of n=30 health professionals revealed a general acceptance of Internet-based programs for schizophrenia (53% acceptable, 47% acceptable after empirical evaluation) and specific contraindications (e.g., severe psychotic symptoms; 73%). People with schizophrenia highlighted the attractiveness of self-help interventions due to a wish for empowerment and for opportunities to strengthen self-efficacy. Conclusions: Risks, limitations and chances of Internet-based programs for patients with schizophrenia will be discussed.

Peer Acceptance and Friendship as Predictors of Early Adolescents' Adjustment Across the Middle School Transition

This study examines several aspects of adolescents' pretransition peer relationships as predictors of their adjustment to middle school. Participants were 365 students (175 boys; 99% Caucasian) involved in the Time 1 (the spring of fifth grade) and Time 2 (the fall of sixth grade) assessments. Adolescents completed measures that assessed peer acceptance, number of friends, the quality of a specific mutual friendship, loneliness, depression, self-esteem, and involvement in school. Academic achievement and absentee data were obtained from student files. Regression analyses indicated that the pretransition peer variables predicted posttransition loneliness, self-esteem, school involvement, and academic achievement. The patterns of prediction varied slightly for each adjustment variable, with the most robust relationship being between peer acceptance and achievement. Results of repeated-measures MANOVAs indicated no differential changes in adjustment across time by gender. Implications for including a peer component in programs that prepare students for the middle school transition are discussed.

RELATIONS AMONG REMEMBERED PARENTAL ACCEPTANCE AND BEHAVIORAL CONTROL IN CHILDHOOD, ADULTS' CURRENT PSYCHOLOGICAL ADJUSTMENT, AND CAREER INDECISIVENESS

This study tested the hypothesis that career indecisiveness among men tends to be associated with different levels of self-reported psychological adjustment and with different remembrances of parental (maternal and paternal) acceptance and behavioral control in childhood from those of women. One hundred twenty-six respondents ages 17 through 54 (M = 23.7 years, SD = 8.21 years) participated in this study. Thirty-seven where males; 90 were females. Measures used in this study included the Career Decision Scale, the Adult version of the Parental Acceptance-Rejection/Control Questionnaire for mothers and for fathers, and the Adult version of the Personality Assessment Questionnaire. Both men and women remembered their mothers as well as their fathers as being loving in childhood. Additionally, men and women remembered both parents as being moderately behaviorally controlling in childhood. Finally, both men and women reported a fair level of psychological maladjustment. And on average, both men and women were fairly indecisive about their careers. Results of analyses supported the hypothesis in that career indecisiveness among women but not men was significantly correlated with remembered maternal and paternal acceptance in childhood, as well as with self-reported psychological adjustment and age. However, only women’s self-reported psychological adjustment made a significant and unique contribution to variations in their reports of career indecisiveness. None of the predictor variables were significantly associated with career indecisiveness among men.

The influence of transparency on self-evaluation as part of the university accreditation process in Peru.

In order to show the choice of transparency as the guiding principle of the accreditation process, the article evaluates its influence on the fundamental subprocess of self-evaluation, thereby confirming that transparency is an essential tool for continuous improvement of academic processes and those of educational quality management. It fosters educational innovation and permits the sustainability of the continuous accreditation process over time, resulting in greater probabilities of university self-regulation through systemization of the process, with the objective of continuous improvement of university degree programs. The article analyzes the influence of transparency on each activity of the self-evaluation process according to the Peruvian accreditation model prepared under the total quality approach, as a reference for other accreditation models, proposing concrete transparency actions and evaluating its influence on the stakeholder groups in the self-evaluation process, as well as on the efficiency and effectiveness of the process. It is concluded that transparency has a positive influence on the training of human capital and the formation of the university?s organizational culture, facilitating dissemination, understanding and involvement of the stakeholder groups in the continuous improvement of accreditation activities and increasing their acceptance of change and commitment to the process. It is confirmed that transparency contributes toward increasing the efficiency index of the self-evaluation process by reducing operating costs through adequate, accessible, timely contribution of information by the stakeholders and through the optimization of the time spent gathering relevant information. In addition, it is concluded that transparency contributes toward increasing the effectiveness index of self-evaluation by facilitating the achievement of its objectives through synthetic, useful, reliable interpretation of the education situation and the formulation of feasible improvement plans based on the adequacy, relevance, visibility, pertinence and truthfulness of the information analyzed.

Predictors of men's acceptance of modern contraceptive practice: Study in rural Vietnam

Studies have shown family planning adoption is likely to be more effective for women when men are actively involved. The transtheoretical model of behavior change was used to examine men's involvement in general contraception and intrauterine device (IUD) use by their wives. The study was carried out in rural Vietnam with 651 eligible participants. Cons of IUD use for men in precontemplation and contemplation/preparation were significantly higher than those in the action/maintenance stages, whereas the reverse was true for pros of IUD. The self-efficacy for convincing wife to have IUD in precontemplation was significantly lower than for those in higher stages. Women's education and ages, spontaneous recall of modem contraceptive method, cons for IUD, and self-efficacy for contraception and for convincing wives to get IUD inserted (or continue use) were significant predictors of men's readiness to accept IUD. Interventions are targeted to reduce cons and increase self-efficacy for IUD use.

Antecedents and consequences of service quality in consumer evaluation of self-service internet technologies

Advances in technology coupled with increasing labour costs have caused service firms to explore self-service delivery options. Although some studies have focused on self-service and use of technology in service delivery, few have explored the role of service quality in consumer evaluation of technology-based self-service options. By integrating and extending the self-service quality framework the service evaluation model and the Technology Acceptance Model the authors address this emerging issue by empirically testing a comprehensive model that captures the antecedents and consequences of perceived service quality to predict continued customer interaction in the technology-based self-service context of Internet banking. Important service evaluation constructs like perceived risk, perceived value and perceived satisfaction are modelled in this framework. The results show that perceived control has the strongest influence on service quality evaluations. Perceived speed of delivery, reliability and enjoyment also have a significant impact on service quality perceptions. The study also found that even though perceived service quality, perceived risk and satisfaction are important predictors of continued interaction, perceived customer value plays a pivotal role in influencing continued interaction.

An investigation into the acceptance of online banking in Saudi Arabia

Although a regional leader, Internet banking in Saudi Arabia is yet to be fully utilised as a value-adding tool to improve customer relationships and achieve cost advantages. The aim of this study was to identify the factors that encourage customers to adopt online banking in Saudi Arabia. The research constructs were developed based on the technology acceptance model (TAM) and incorporated some extra important control variables. The model was empirically verified to examine the factors influencing the online banking adoption behaviour of 400 customers. The findings of the study suggests that the quality of the Internet connection, the awareness of online banking and its benefits, the social influence and computer self-efficacy have significant effects on the perceived usefulness (PU) and perceived ease of use (PEOU) of online banking acceptance. Education, trust and resistance to change also have significant impact on the attitude towards the likelihood of adopting online banking. The implications of the findings are discussed and suggestions for future research are presented.

Consumer engagement with self-expressive brands:brand love and WOM outcomes

Purpose: The purpose of this paper is to explore attitudes of consumers who engage with brands through Facebook "likes". It explores the extent to which these brands are self-expressive and examines the relationship between brand "liking" and brand outcomes. Brand outcomes include brand love and advocacy, where advocacy incorporates WOM and brand acceptance. Design/methodology/approach: Findings are presented from a survey of Facebook users who engage with a brand by "liking" it. Findings: Brands "liked" are expressive of the inner or social self. The study identifies a positive relationship between the self-expressive nature of brands "liked" and brand love. Consumers who engage with inner self-expressive brands are more likely to offer WOM for that brand. By contrast, consumers who engage with socially self-expressive brands are more likely to accept wrongdoing from a brand. Research limitations/implications: The research is exploratory and is limited to consumers who are engaged with a brand through "liking" it on the Facebook social network. Practical implications: The study offers suggestions for managers seeking to enhance brand engagement through Facebook "liking", and to encourage positive brand outcomes (such as WOM) among consumers already engaged with a brand on Facebook. Originality/value: This paper provides new insights into consumer brand engagement evidenced through Facebook "liking". It charts the relationship between "liked" self-expressive brands and brand love. Distinctions are drawn between brand outcomes among consumers who "like" for socially self-expressive reasons, and consumers who are brand engaged by "liking" to express their inner selves. © Emerald Group Publishing Limited.

A pilot study to evaluate the self-medication system for liver transplant patients at the Queen Elizabeth Hospital in Birmingham

Background and Objective: Medication non-compliance is a considerable obstacle in achievinga therapeutic goal, whichcan result in poorerhealthcare outcomes, increased expenditure, wastage and potential for medication resistance. The UK Government’s Audit Commission’s publication ‘A Spoonful of Sugar’1 addresses these issues and promotes self-medication systems as a possible solution. The self-medication system within the Liver Transplant Unit (LTU) was implemented to induct patients onto new post- transplantation medication regimes ready for discharge. The system involves initial consultations with both the Liver Transplant Pharmacist and Trans- plant Co-ordinator, supported with additional advice as and when necessary. Design: Following ethical approval, evaluation of the self-medication sys- tem for liver transplant patients was conducted between January and March 2004 via two methods: audit and structured post-transplantation interview. The audit enabled any discrepancies between current Hospital guidelines and Liver Transplant Unit (LTU) practices to be highlighted. Patient interviews generated a retrospective insight into patient acceptance of the self-medication system. Setting: LTU, Queen Elizabeth Hospital, Birmingham, England. Main Outcome Measures: LTU compliance with Hospital self-medication guidelines and patient insight into self-medication system. Results: A total of seven patients were audited. Findings illustrated that self- medication by transplant patients is a complex process which was not fully addressed by current Hospital self-medication guidelines. Twenty-three patients were interviewed, showing an overwhelming positive attitude to- wards participating in their own care and a high level of understanding towards their individual medication regimes. Following a drugs counselling session, 100% of patients understood why they were taking their medica- tion, and their doses, 95% understood how to take their medication and 85% were aware of potential side effects. Conclusions: From this pilot evaluation it can be stated that the LTU self-medication system is appreciated by patients and assists them in fully understanding their medication regimes. There appear to be no major defects in the system. However areas such as communication barriers and on-going internet education were illustrated as areas for possible future investigation. References: 1. Audit Commission. A spoonful of sugar – medicines management in NHS hospitals. London: Audit Commission; 2001.